1967 U.S. Senate Appropriations Committee Budget Testimony, 89th Congress 2nd Session, March 14, 1966
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LABOR—HEALTH;, EDUCATION, AND WELFARE APPROPRIATIONS FOR FISCAL YEAR 1967 HEARINGS BEFORE THE SUBCOMMITTEE OF THE COMMITTEE ON APPROPRIATIONS UNITED STATES SENATE EIGHTY-NINTH CONGRESS SECOND SESSION ON H.R. 14745 .MAKING APPROPRIATIONS FOR THE DEPARTMENTS OF LABOR, AND HEALTH, EDUCATION, AND WELFARE. AND RELATED AGENCIES, FOR THE FISCAL YEAR ENDING JUNE 30, 1967, AND FOR OTHER PURPOSES PART 1 (Pages 1 through 1385) (Wednesday, March 2,1966, through Monday, March 28,1966) Printed for the use of the Committee on Appropriations 60-302 U.S. GOVERNMENT PRINTING OFFICE WASHINGTON: 19660073646_000002.txt

Page  2 National Library of Medicine STATEMENT OF DR. MARTIN M. CUMMINGS, DIRECTOR, NATIONAL LIBRARY OF MEDICINE, ACCOMPANIED BY SCOTT ADAMS. DEPUTY DIRECTOR, NATIONAL LIBRARY OF MEDICINE; DR. MARJORIE P. WILSON, ASSOCIATE DIRECTOR FOR EXTRAMURAL PROGRAMS, NATIONAL LIBRARY OF MEDICINE; JAMES D. IS- BISTER, EXECUTIVE OFFICER, NATIONAL LIBRARY OF MEDI- CINE; DR. LEO J. GEHRIG, DEPUTY SURGEON GENERAL; HARRY L. DORAN, CHIEF FINANCE OFFICER; AND JAMES F. KELLY, DEPARTMENT COMPTROLLER. Appropriation Estimate "national library op medicine "To carry out section 301 of the Act and for expenses, not otherwise provided for, necessary to carry out the National Library of Medicine Act (42 U.S.C. 275), [$5,510,000] and the Medical Library Assistance Act of 1965 (79 Stat. 1059), $19,231,000, of which $13,600,000 shall remain available until June 30, 1968." explanation of language change The change in language is requested to include authorization for the use of funds to carry out the Medical Library Assistance Act of 1965 under this appro- priation. Amounts available for obligation 1966 1967 Appropriation.......__________________________...........________ Proposed supplemental____________________________....._________ Transferred to "Office of the Surgeon General, salaries and expenses". Total____________.....____________________________________ $5, 510,000 4,175,000 -1,000 9, 684, 000 $19,231,000 19,231, 000 Obligations by activity 1966 estimate 1967 estimate Increase or decrease Posi-tions Amount Posi-tions Amount Posi-tions Amount Grants: $945,000 120,000 765,000 $1,000,000 120,000 1,000,000 7,500,000 2,935,000 +$55,000 (c) Training-____......__________ +235,000 +7,500,000 2,200,000 +735,000 4,030, 000 12,555,000 +8,525,000 Direct operations: 322 30 5,314,000 340,000 344 30 6,061,000 615,000 +22 +747,000 (6) Review and approval of grants +275, 000 Total direct operations.......- 352 5,654,000 374 6,676.000 +22 +1,022,000 Total obligations.............- 352 9,684,000 374 19,231,000 +22 +9,547,000 9010073646_000003.txt

Page  3 902 LABOR-HEALTH, EDUCATION, WELFARE APPROPRUTIONS Obligations by object 1966 estimate 1967 estimate Increase or decrease Total number of permanent positions..... Full-time equivalent of all other positions. Average number of all employees________ 362 6 315 Personnel compensation: Permanent positions.......____ Positions other than permanent. Other personnel compensation... $2,335,000 50,000 10,600 Total personnel compensation___.......________ 12 Personnel benefits____________________................ 21 Travel and transportation of persons........____......... 22 Transportation of things.................................. 23 Rent, communications, and utilities...................... 24 Printing and reproduction................................ 25 Other services_______......__________.................. Project contracts__'................................... Services of other agencies__................._______ Payment to "National Institutes of Health manage- ment fund"......................................... 26 Supplies and materials.................................... 31 Equipment..............._________..................... 41 Grants, subsidies, and contributions...................... 2,395,500 183,000 90,000 3,500 140,000 269,000 80,000 1,587,000 108,000 510,000 109,000 179,000 4,030,000 Total obligations by object. 374 8 337 +22 0 +22 $2,634,600 54,000 10,500 2,699,100 207,400 102,000 5,500 176,400 279,000 80,000 2,027,800 134,000 668,200 112,800 193,800 12,656,000 9,684,000 19,231,000 +$299,600 +4,000 +303,600 +24,400 +12,000 +2,000 +86,400 +10,000 +440,800 +26,000 +148,200 +3,800 +14,800 +8,525,000 +9,647,000 Summary of Changes 1966 enacted appropriation___________________________________ $5, 510, 000 Proposed supplemental_____....._____________________________ 4, 175, 000 Transferred to "Office of the Surgeon General, Salaries and expenses". — 1, 000 1966 total estimated obligations_________________________ 9f 684, 000 1967 estimated obligations________________........._____ 19, 231, 000 Total change....................._...............____+9, 547, 000 Increases: Mandatory: 1. Annualization of 52 positions new in 1966____________ 2. Increase in cost of utilities and building maintenance services_____________________ 144, 400 18, 500 Subtotal, mandatory increases. 162, 900 Program (intramural): 1. Expanding the collection (4 positions)_______________ 2. Improving reference services (3 positions)_________III 3. Unpublished records program ( 1 position)______ " 4. Improving bibliographic services through MEDLARS (6 positions)___________________________________ 5. New computer system design (1 position).lllllllllll 6. Graphic image storage and retrieval (1 position).. I III 7. Automation of technical services (5 positions)________ 8. Strengthening Library management (1 position) 9. Decentralized MEDLARS_____________. Program (extramural): 10. Construction of Medical Library facilities___________ 11. Research and development 12. Training_____________________llllllllllllllllll' 13. Publications support_____________llllllllllllll" 14. Medical Library resources______________llllllll" 15. Review and approval of grants and" contracts"IIIIII 77, 000 35, 000 10, 000 75, 000 154, 000 50, 000 118, 400 13, 000 74,000 7, 500, 000 155,000 235, 000 35, 000 700,000 188, 700 Subtotal, program increases_____________________ gt 420,100 Gross increases___ Decreases: Nonrecurring equipment cost. Total net change requested. 9, 583, 000 -36,000 +9, 547, 0000073646_000004.txt

Page  4 LABOR-HEALTH, EDUCATION, WELFARE APPROPRIATIONS 903 EXPLANATION OF CHANGES Expanding the collection An increase of $77,000 and four positions would contribute to expanding the scope of library acquisitions, accelerating the rate of procurement and to catalog- ing the additional 2,500 books and journals acquired. Improving reference services An increase of $35,000 and three positions will permit the library to maintain its reference services in 1967 at an acceptable level of competence and responsive- ness, and give special support to Federal health information programs. Unpublished records An increase of $10,000 and one position will enable the library to acquire organize, and preserve some manuscripts, personal papers, tape recorded oral interviews, and correspondence pertaining to the significant developments in medicine. Improving bibliographic services through medlars An increase of $75,000 and six positions will contribute to a more thorough indexing of medical literature and expansion of "demand search" services, and provide for the accomplishment of increased workload in computer operations. New computer system design An increase of $154,000 and one position will enable the library to begin repro- graming and conversion to a new computer system scheduled for installation in 1968. Graphic image storage and retrieval An increase of $50,000 and one position is needed to step up the conversion of deteriorated paper to microform and further the development of a mechanized graphic retrieval system. Automation of technical services An increase of $118,400 and five positions will permit the library to implement a centralized service that will make information about new publications more readily accessible throughout the country and reduce the national costs of dupli- cative cataloging, a major factor in all research library budgets, and will enable the library to begin applying automatic data processing techniques in purchasing literature and maintaining serial records. Strengthening library management An increase of $13,000 and one position for administrative management is necessary as a result of the expansion of library programs and management responsibilities. Decentralized MEDLARS An increase of $74,000 will support two additional university-based decen- tralized MEDLARS search centers during the last half of 1967. Construction of medical library facilities Seven million five hundred thousand dollars will inaugurate the construction grant program in 1967 and support about 10 construction or renovation projects. Research and development An increase of $155,000 in 1967 will bring the total funding for this program up to $1,500,000 which will provide for about 30 grants or contracts for necessary research directed toward improving distribution of documents, bibliographic materials and information to health scientists and practitioners. Training An increase of $235,000 will bring the total funding for this program in 1967 up to $1 million which will support about 20 to 24 training projects and produce 100 to 125 additional trained individuals each year to undertake careers in medical librarianship and related biomedical information specialties. Publications support An increase of $35,000 will bring the total for this program up to $780,000 in 1967 and will provide support needed for important biomedical publications activities such as translations, bibliographies, critical reviews, indexes, and abstracting services.0073646_000005.txt

Page  5 904 LABOR-HEALTH, EDUCATION, WELFARE APPROPRIATIONS Medical library resources An increase of $700,000 will bring the total for this program to $2,700,000 in 1967 and will enable the library to further implement a program of grant support to local medical libraries for strengthening collections, improving access to hold- ings, introducing new technologies in health science librarianship and acquiring needed equipment. Review and approval of grants and contracts An increase of $188,700 in 1967 will be used to reimburse the NIH management fund for reimbursable obligations for grants and contracts management services, support advisory committees, and other administrative expenses associated with an expanded extramural program. Library operations and research 1966 estimate 1067 estimate Increase or decrease Posi-tions Amount Posi-tions Amount Posi-tions Amount Personnel compensation and benefits..... 352 $2,678,600 7,106,600 374 $2,906,600 16,324,500 +22 $328,000 0,219,000 Total 352 9,684,000 374 19,231,000 +22 0,547,000 Summary of program 1966 1967 Increase or decrease Posi-tions Amount Posi-tions Amount Posi-tions Amount Medical Library assistance: Grants and contracts: Research and development grants____ $945,000 400,000 $1,000,000 500,000 +155,000 +100,000 Contracts (from library operations)... Total, research and development___ 1,345,000 120,000 766,000 1,500,000 120,000 1,000,000 7,500,000 +155,000 Special projects (fellowship grants)___ Training grants +286,000 +7,500,000 Construction grants________.....____ Publication support: Grants..........__________....... 200,000 645,000 235,000 645,000 +35,000 Contracts (from library opera- Total, publication support_____ 745,000 2,000,000 780,000 2,700,000 +36,000 +700,000 Library resources grants_____.....___ Subtotal, grants and contracts_____ 4,975,000 13,600,000 +8,626,000 Direct operations: Library operations_____________________ 322 6,314,000 -945,000 344 6,061,000 -1,046,000 +22 +747,000 -100,000 Less contracts included above___________ Intramural library operations........... 322 (2) 30 352 4,369,000 (400,000) 340,000 0,684,000 344 (2) 30 6,016,000 (474,000) 615,000 +22 +647,000 (+74,000) +275,000 Decentralized MEDLARS........______ Review and approval of grants and con-tracts____________________________ Total, National Library of Medicine____ 374 19,231,000 +22 +9,647,000 MEDICAL LIBRARY ASSISTANCE, GRANTS AND CONTRACTS The Medical Library Assistance Act of 1965 authorizes a program of support and assistance to the health sciences libraries of the Nation in seven major areas: (1) Conduct of research in medical library science, and the development of new systems and techniques for processing, storing and retrieving infor- mation;0073646_000006.txt

Page  6 LABOR-HEALTH, EDUCATION, WELFARE APPROPRIATIONS 905 (2) Compilation and dissemination of important biomedical information through the award of special scientific grants to scholars; (3) Training of biomedical librarians and information specialists; (4) Construction of new, and improvement of existing library facilities; (5) Financial support of biomedical communications; (6) Improvement and expansion of basic library resources, particularly literature collections; (7) Development of regional medical libraries. The largest part of the library's extramural program deals with the implemen- tation of this act. However, programs of extramural grants in the history of medicine and drug literature, training in medical librarianship, and contract support of biomedical publications, in existence at the time of the act's passage, will be continued as well. Research and development.—Due to its volume and character, published bio- medical literature poses difficult problems of information storage, retrieval, and transmission. The uses to which this information is put are of such vital im- portance in terms of the health needs of the Nation that the urgency for improving these aspects of its handling cannot be too strongly emphasized. Nearly all phases of current health science library practice need to be reassessed to develop more efficient skills and technologies. In addition, research is needed in the uses of published information by scientists, teachers and practitioners, whose require- ments for this information are poorly understood and need to be examined critically. Studies are also needed to analyze the interrelationships between institutions which supply informational services to health scientists and provide data which may lead to more efficient distribution of documents and services. The program of research in the history of the life sciences will be continued. Last. year the Senate Appropriations Committee added $30,000 above the 1966 Presi- dent's budget request for the history of medicine grant program. With these funds we were able to award two grants for investigations in this field. The $1,500,000 requested will provide for about 30 grants or contracts to support research and development projects as described above. The budget for 1966 and 1967 reflects the application of the newly authorized cost sharing arrange- ments to competing research grant projects (new and renewal). This cost sharing plan considers the full indirect cost of the research project in arriving at the Federal and non-Federal share. For continuation of previously approved projects the earlier limitation of 20 percent or less for indirect costs is applied with an assurance of some sponsor cost participation. Special scientific projects (fellowships).—With the very great increases in pro- grams for the conduct of medical research has come a concomitant increase in the rate of publication of scientific results. This makes it necessary that the results be compiled, reviewed, evaluated, and placed in historical perspective in order that they may be made available to busy practitioners and scientists in a form in which they are most useful. Opportunities for qualified scientists to devote a full-time period to such an effort with the resources of major research libraries such as NLM at their disposal are almost nonexistent. The Medical Library Assistance Act authorizes awards for such purposes. The $120,000 re- quested will allow the support of from 6 to 10 such awards. Training.—There are only about 3,000 librarians with specialized training or experience in health science librarianship to serve the 6,000 health science libraries in the country. In order to help overcome the existing manpower deficits, ad- ditional training activities will be initiated and existing ones expanded. The requested $1 million will support about 20 to 24 training projects. The overall effort supported by the projects will produce 100 to 125 additional trained persons each year to undertake careers in medical librarianship and related biomedical information specialities. Support will also be extended to activities designed to provide more intensive training than has been available in the past and to update the skills of personnel now practicing in this field. Construction of medical library facilities.—The Association of American Medical Colleges has reported that a survey conducted in 1964 showed that its member institutions required more than $87 million for medical library construction and renovation. This sum represents about $65 million in Federal funds when the 75 percent matching rate as allowed in the Medical Library Assistance Act of 1965 is applied. The survey did not take into account the needs of free-standing health science libraries and those in other health professions educational institu- tions. Provision of the library facilities needed by free-standing and other libraries will require an additional $10 million in Federal funds. The $7,500,000 requested will inauguarate the construction grant program in 1967 and support about 10 construction or renovation projects.0073646_000007.txt

Page  7 906 LABOR-HEALTH, EDUCATION, WELFARE APPROPRIATIONS Publications support.—The Medical Library Assistance Act of 1965 authorises a program of grants and contracts for the support of biomedical publications. The program will be implemented by support of publications other than those which contain original journal articles. Examples of the types of activity sup- ported under this authority include translations, bibliographies, critical reviews, indexes, and abstracting services. Under other legislative authority the library has supported publications activities for a number of years. The $780,000 re- quested for 1967 will support approximately five grants for $235,000 and nine contracts for $545,000. . Medical library resources.—The health science library resource need is of great magnitude and is so directly related to health research, to the training of health manpower, and to providing the information needed by the health science practitioner that it requires special attention. As the House Interstate and Foreign Commerce Committee indicated in reporting the Medical Library Assistance Act, "resource needs for libraries in schools of medicine, dentistry, osteopathy, nursing, and hospitals are estimated to exceed $85 million." The program of grant support in this area authorized by the Medical Library Assistance Act of 1965 will provide for strengthening collections of health science libraries through the purchase of books, journals, and other informational resources; for improving the access to the holdings of the libraries by providing assistance in cataloging, binding, and other services and procedures for processing library re- source materials; for the introduction of new technologies in health science librar- ianship; and for the acquisition of photoduplication devices, facsimile equipment, film projectors, microfilm readers, and other needed equipment. Approximately 225 health science libraries will receive grants in 1967 from the $2,700,000 re- quested. / DIRECT OPERATIONS Library operations Expanding the collection.—The library has a basic responsibility to gather> organize, and preserve all printed information throughout the world which can be used to advance medical research, teaching, and practice. The scope> of scientific inquiry is constantly broadened in the search for relevant information. As a result of the broadened base of medicine, the library must constantly locate and acquire additional scientific books and journals on subjects that have only recently become necessary source materials. In addition to broadening the scope of its coverage, the library must meet the steadily rising volume and costs of scientific publications. Twelve percent more scientific books were published in 1962 than in 1961, 18 percent more in 1963 than in 1962, and 24 percent more in 1964 than in 1963. From 1956 to 1964 the average price of American medical periodicals increased from $9.09 to $13.25 (46 percent) and that of American medical books, increased from $7.73 to $11.22 (45 percent). Delay in purchasing this literature on a current basis leads to serious problems of locating commercial sources and, more importantly, denies ready user access to important information. Also, some medical literature goes out of print quickly and the library is unable to acquire it if it does not act promptly. This is par- ticularly true of some foreign literature. Four positions and $77,000 would be used to expand the scope of coverage, to accelerate the rate of procurement and to catalog the additional 2,500 books and journals acquired. Reference services.—The library attempts to meet a continuing need for pro- fessional reference assistance at local, national, and international levels. In addition to assisting research investigators in the local area, the library has become recognized as a comprehensive source of materials by medical practitioners, scientists, and librarians throughout the world. MEDLARS has added a new dimension to the service capabilities of the library, and this has resulted in additional demands on our reference staff. Traditional techniques must now be integrated with computer operations to be fully respon- sive to highly specialized requests for literature search and research. There was a 56-percent increase in total reference services in 1965 over 1963. A major impact has been felt in number of mail inquiries answered which increased by over 30 percent in 1965 over the previous year. It is estimated that 1967 in- creases over 1964 will be 17 percent for total requests received and 30 percent for interlibrary loans. Three new positions and $35,000 are requested for 1967 to maintain reference services at an acceptable level of competence and responsiveness, andto provide special support to Federal health information programs.0073646_000008.txt

Page  8 LABOR-HEALTH, EDUCATION, WELFARE APPROPRIATIONS 907 Unpublished records.—By congressional mandate, the library attempts to collect all published information on medicine, and though this literature reflects the results of medical research and practice, it often fails to place the scientists' work in a social and historical perspective. It is important to know the reasons and social pressures which result in a particular research project or institutional policy if we are to fully understand the national quest for good health. For such information, it is necessary to go beyond the printed record to manuscript sources, tape-recorded oral interviews, personal papers and corre- spondence. The library proposes to acquire, organize, and preserve resources of this nature relating to significant developments in medicine. One position and $10,000 are requested for this program in 1967. Improving bibliographic services through MEDLARS.—MEDLARS, the library's computer-based information storage and retrieval system, has been in operation since January 1964. By the end of August 1965, 330,000 references to medical journal articles had been entered into the computer files and printed in the monthly and annual Index Medicus. The following specialized bibliographies are being produced on a recurring basis: Bibliography of Medical Reviews; Index to Rheumatology; Cerebrovascular Bibliography; Index to Dental Litera- ture; and Bibliography of Fibrinolysis, Thrombolysis, and Blood Clotting; and others are being developed. More than 2,600 demand searches have been performed in response to requests from outside the library, and many searches have been performed for internal purposes. To allow MEDLARS to make its optimum contribution to the medical sciences, it is essential that all significant medical communications be indexed for publi- cation and retrieval purposes. It has been estimated that there are about 300,000 significant documents in the current biomedical literature that should be included in MEDLARS each year. Closely related to the problem of increasing production from MEDLARS is the improvement of the quality of the bibliographic products of the system through continued development of medical subject headings. It is important that the library's subject heading specialists keep abreast of new medical concepts and develop terminology in such closely related areas as biochemistry, biophysics, and the environmental, social, and behavioral sciences. To reach a production goal for 1967 of 180,000 new articles for Index Medicus (bringing the total data file to over 650,000 articles), 15 specialized recurring bibliographies, and 7,200 demand searches, a total of 6 new positions and $75,000 are required. These funds will be used to support additional indexing, bibli- ographic services, computer operations, and to rent additional computer time from another Government agency. New computer system design.—The rapid development and use of new programs and the expansion of others has caused a reexamination of the library's future data processing requirements—both equipment and programs. New systems currently under development include (1) an on-line input system to MEDLARS to permit direct communication between indexer and computer; (2) an automated acquisition and cataloging system (the cataloging subsystem is now being tested and will be operational on January 1, 1966); (3) a graphic image storage and retrieval system which will be closely linked to the MEDLARS computer search capability; (4) a drug literature program with chemical search capabilities being added to MEDLARS; and (5) development of an intramural research and development program in information retrieval and scientific documentation. Rapid advances in computer technology along with important developments in the field of information retrieval will be useful in modernizing and expanding the MEDLARS system in the near future. For example, the recent development of very large capacity, random access storage devices could be applied to MEDLARS in improving the machine search process. The MEDLARS decentralization pro- gram is also expanding. In 1966 three new search centers will be added to the two already in existence. The library had originally planned to install a new computer system during the period 1969-70. Because of the rapid growth of medlars services (650 hours of H-800 computer time were logged in December 1965), and also the requirements of the newly developing systems described above, the library believes that the installation of new equipment must be advanced to 1968. The library now plans to follow a modified timetable as follows: 1966: Develop systems specifications for (a) a new on-line input subsystem either compatible with the existing computer operating system or compatible with a new computer system if this proves to be more economical; and (b) a total NLM revised projected system requirements.0073646_000009.txt

Page  9 908 LABOR-HEALTH, EDUCATION, WELFARE APPROPRIATIONS 1967: Solicit and evaluate proposals for a revised or a totally new computer equipment system. Begin reprograming and conversion (by contraot). 1968: Complete equipment installation, reprograming, and conversion. The library will proceed to develop system specifications on the basis of the timetable described above for 1966, and request proposals later this fiscal year so that a contract may be let and reprograming and conversion begun in 1967. This would enable installation of the new equipment in 1968 by which time it will be critically needed. By 1968 the library will have utilized the Honeywell-800 computer for 4# years. Although the computer was purchased in 1963, the rental amounts that would have accrued had the machine been rented will have exceeded the purchase and maintenance costs before 1968. One position and $154,000 are requested to begin reprograming and conversion for this program in 1967. Graphic information storage and retrieval.—The library has identified 37 million pages in its collection as being in an advanced state of deterioration including 5 million pages of materials in such poor condition that a single normal usage will probably result in irreplaceable loss of information. In its archival capacity, NLM serves to guarantee the existence to inquirers in the United States of any publication relating to medicine, regardless of date or country or language of origin. As other libraries discard disintegrated materials, NLM must guarantee its survival for uses not yet foreseen. This responsibility derives from its statu- tory mission. Additional funds in the amount of $220,000 were recommended by the Senate Appropriations Committee for the use of this program in 1966. These funds allowed the library to make progress in the preservation of poor paper. Additional microphotographers have been hired; new equipment has been pur- chased, and old has been rehabilitated. The results of a collaborative study on ghotoduplication system requirements by the library and the National Bureau of tandards were received and a graphic image storage and retrieval conference was held in Bethesda in November 1965. On the basis of information and specifica- tions in the report and the results of the conference, the National Library of Medicine is now preparing to contract for a pilot microfilming project to film approximately 1 million pages of literature. One position and $50,000 are requested to step up conversion of deteriorated paper to microform and further the development of a mechanized graphic image storage and retrieval system in 1967. Automation of technical services.—Central to the functions of a national library is the assumption of responsibility for leadership in the development of new technology for the improvement of library methods. In the case of the NLM, the capability for leadership has been significantly enhanced by the data processing resource represented by MEDLARS; NLM is the only medical library in the world with a computerized reference retrieval system. To date the system has been utilized to produce indexes, bibliographies, and mechanized literature searches. Using the same basic computer hardware, the potential exists for systems application to library operations in such a way as to provide benefits not only for NLM itself but for 6,000 other medical libraries which may use computer-produced catalogs. High priority has been assigned to the mechanization of library cataloging, not only because this represents a significant added input to the existing MEDLARS system but also because of the economic benefits to other libraries which now independently, at high cost, are cataloging duplicatively the same books. In January 1966 NLM plans to begin to use MEDLARS to initiate centralized cataloging for the field of medical literature. This centralized cataloging service will not only make information about new medical publications available more promptly throughout the country but will decrease the total national costs of cataloging, a major factor in all research library budgets. During 1967 it is planned to extend the application of automatic data processing to two other technical services: (1) procurement of literature and (2) maintenance of the serial record which lists all of the journals in the Library's collection. Im- plementation of this plan will give the Library an improved system for process- ing the procurement of literature, for controlling the assimilation of new acquisi- tions into the Library's collection, and for expediting the preparation and main- tenance of the serial recora making it possible to provide more timely information about the journal holdings of the Library. To complete the Library's planned program of automating its procurement, serial record, and cataloging procedures, additional systems support is needed— systems analysts and programers. The total effort would require five (5) new0073646_000010.txt

Page  10 LABOR-HEALTH, EDUCATION, WELFARE APPROPRIATIONS 909 positions and $118,400, and would result in a high level of automation with benefits and savings to the entire medical library community. Strengthening library management.—The expansion of existing programs and the initiation of new and complex activities will create management problems of a degree of difficulty not previously experienced. Overall administrative manage- ment cognizance must be taken of the greatly expanded grants and contracts programs under the Medical Library Assistance Act as well as the expansion of existing budget and personnel functions. One position and $13,000 are requested for this program in 1967. MEDLARS DECENTRALIZATION MEDLARS is the only operational computerized ref erence retrieval system dealing with published medical literature. Exploitation of this development through extending bibliographic search capability to regional centers is clearly in the public interest. The Library began a pilot program of decentralization during 1965. Under this pilot program two centers were established, one at the Uni- versity of Colorado which has the same computer equipment as NLM and one at the University of California at Los Angeles which has different computer equip- ment. These pilot projects have shown the desirability and feasibility of de- centralizing the bibliographic search capability of MEDLARS. Broad interest in the program exists both in the United States and overseas. More than 30 Ameri- can universities have expressed their desire to function as local search centers. Due to an increase of $250,000 above the President's budget request recommended by the Senate Appropriations Committee, the Library's budget for 1966 will support five decentralized centers. An increase of $74,000 is requested to support two additional centers during the last half of 1967. REVIEW AND APPROVAL OP GRANTS AND CONTRACTS An increase of $275,000 is requested to reimburse the NIH management fund for grants and contracts management services, to support advisory committees, to rent space to house the extramural program staff since existing office space at the National Library of Medicine is not adequate, and to provide for other ad- ministrative expenses associated with an expanded extramural program such as the National Library of Medicine Board of Regents, the Subcommittee of the Board of Regents for Extramural Programs, the National Library of Medicine Training Committee, and other committees needed for program advice. New positions requested, fiscal year 1967 Orade Annual salary Librarians (2).....................----- Administrative officer............----- Digital computer systems administrator. Medical literature analyst........______ Librarian......---------.....________ Systems analysts (2)....................- Librarians (3).......................___ Programers (2)_____________________ Systems analyst.................______ Librarians (2)......_________________ Programer..............-.......------- Do........_____________________ Indexer............__________________ Computer operator__________________ Clerk.......................__________ Typist....................—......---- GS-15 OS-15 GS-13 GS-13 GS-13 GS-13 GS-12 GS-12 GS-12 GS-11 GS-11 GS-S GS-9 GS-5 GS-4 GS-3 $34,110 17,055 14,685 14,685 12,510 25,020 31,857 21,238 10,610 17,922 8,061 7,479 7,479 5,181 4,641 4,149 Total (22). 237,591 Contribution of National Library of Medicine Senator Hill. Now, Dr. Cummings. You may proceed. Dr. Cummings. Mr. Chairman and members of the committee, this year the National Library of Medicine completes its first decade in the Public Health Service. Ten years have passed since the enactment of the Hill-Kennedy bill (Public Law 84-94 l),*the basic0073646_000011.txt

Page  11 910 LABOR-HEALTH, EDUCATION, WELFARE APPROPRIATIONS enabling legislation for the National Library of Medicine, and in that time the Library has made great strides in contributing biomedical information support to institutions, scientists, practitioners, and students dedicated to improving the health of the Nation. Four Significant Phenomena During the past decade, four significant phenomena have occurred with profound effects on the National Library of Medicine. First, there is the explosive growth of scientific literature. Second, there is the tremendous expansion of health research accompanied by an in- creasing urgency to apply new knowledge to the improvement of health. Third, there is the resulting sophistication and specialization of health science, education, and practice which has carried the scope of medicine far beyond its earlier boundaries to include physical, mathe- matical, and behavioral sciences. Fourth, there is the so-called cybernetic revolution bringing forth complex, sophisticated computers and other automated equipment to be applied to library development. Senator Hill. There has been a tremendous change in this field, has there not? Dr. Cummings. There certainly has been. These phenomena create both problems and opportunities for those responsible for gathering, processing, and disseminating medical and related scientific information. More information is required faster by the health scientist and practitioner than ever before. Increased Volume of Medical Literature The increased volume of medical and related literature poses difficult handling, retrieval, and dissemination problems. The increased need to apply new knowledge to daily health problems has focused attention on the Library's resources and potential for continuing education of physicians and members of other health professions. The increased sophistication andjspecialization of the health sciences creates literature which is more difficult to analyze and index meaningfully. However, the advances in electronic data processing and other techniques of automation provide the oppor- tunity for librarians, documentalists, and other information spe- cialists to overcome many of the communication problems and achieve improved access to the storehouse of scientific knowledge. The National Library of Medicine has responded to the challenge of the past decade. It has adopted new techniques to perform its basic mission. In doing so, it has been evolving from a traditional research Ubrary to a modern, active biomedical communications center. The success achieved can be appreciated by examining some major National Library of Medicine program accomplishments. MEDLARS Unquestionably, the Library's most significant accomplishment in the past decade was the development ana installation 01 the medical literature analysis and retrieval system (MEDLARS).0073646_000012.txt

Page  12 LABOR-HEALTH, EDUCATION, WELFARE APPROPRIATIONS 911 It was the first application of a computer to the problems of scien- tific information handling in a library. MEDLARS has been outstand- ing in its success. We now have over 400,000 citations to important medical articles on magnetic tape. Rapid searching of this computer data store provides answers to complex bibliographic requests. User reception of MEDLARS has been enthusiastic in the medical community and, as requested by congressional action, the National Library of Medicine has pressed on to decentralize the search and retrieval capability of medlars to achieve the widest possible disemi- nation of information important to the progress of medicine. This effort began in fiscal year 1965. Two decentralized search centers are in operation at this time with three more approved projects to be activated in 1966. These and others will form a reference search and retrieval network serving various regions of the country. Medical Subject Headings (MESH) Development To provide a uniform system of classification for the medical litera- ture and more fully exploit the medlars computer system, the National Library of Medicine has developed, and is continuously revising, medical subject headings (MESH) used to index the medical literature of the world. The list of medical subject headings is a dynamic one that grows as medical science progresses. Automation of Library Services We are vigorously pursuing new applications of automation to the Library's operations. The preparation of the catalog has been automated with significant potential national savings. Literature procurement and maintenance of the serial record are proposed for automation soon. Eventually, we must move to an advance graphic-image storage and retrieval system. Because of the rapid growth of MEDLARS services and the requirements of the newly developing systems, the Library will require new computer equipment in 1968. Senator Hill. That soon, Doctor? Dr. Cummings. Yes, sir. For example, 650 hours of computer time were used in December 1965 and it exceeds that usage now. We are requesting funds in 1967 to begin reprograming and conversion to the new system. Existing Library Services As the cornerstone of the national medical library system, the National Library of Medicine must perform its library services in the most complete and efficient manner possible. The demands on the library for services are very great and ever-increasing. In 1965, we acquired 91,000 publications, cataloged 17,000 titles, bound and repaired 25,000 volumes, answered 21,000 reference inquiries, filled 230,000 loan requests, and microfilmed 2.1 million pages for interlibrary loan. There was a 56-percent increase in total reference services in 1965 over 1963. Senator Hill. Doctor, you speak about binding and repairing 25,000 volumes. Were those old volumes? 60-302—i66----580073646_000013.txt

Page  13 912 LABOR-HEALTH, EDUCATION, WELFARE APPROPRIATIONS Dr. Cummings. Not necessarily old volumes, Mr. Chairman. Many of the current materials which are heavily used also require rebinding. Paradoxically, as I am sure you are aware, many of the older volumes retain their strength and viability better than the new ones. It is mainly in the area of journals where binding and rebinding takes place. Congressional Support of Program Because of the wide range of activity conducted by the library, a keen congressional interest has been shown for our program and has resulted in additions to the library's appropriation above that requested; this was the situation during the first session of the 89th Congress. The history of medicine program was provided an additional $30,000, making a total for this program of $120,000 in 1966. The increase has been used to award two grants to universities for studies in medical history. Without these additional funds, the awards could not have been made. Decentralized MEDLARS received an increase of $250,000, bringing the total funding for that program to $400,000. These funds will be used to support five decentralized MEDLARS search and retrieval cen- ters. The pilot centers at UCLA and the University of Colorado are operational and receiving continued support. A third center has been established at the University of Alabama. The Board of Regents has selected sites for two additional centers—one in the Northeast and one in the Midwest—and contracts will soon be awarded for their support. An increase of $220,000 was provided for poor paper preservation. With these funds the library nas been able to make considerable progress toward preservation of poor paper. Additional micro- photographers have been hired and are now microfilming deteriorated materials at a rate of over 1.5 million pages per year. New equip- ment has been purchased and old has been rehabilitated. The results of a collaborative study on photoduplication system require- ments by the library and the National Bureau of Standards were received and a grapnic image storage and retrieval conference was held in Bethesda in November 1965. On the basis of information and specifications in the report and the results of the conference, the NLM will award a contract for a pilot microfilming project to film approximately 1 million pages. With the 1966 base and the additional $50,000 requested in the 1967 President's budget, the library will be able to microfilm about 4 million pages for preservation in 1967 and make further progress toward developing an advanced graphic-image storage and retrieval system. Preamble of Act In the preamble of the Medical Library Assistance Act of 1965, the Congress recognized that the past two decades have brought an unprecedented expansion of knowledge in the health sciences and, with it, massive growth in the quantity and changes in the nature of biomedical information. It also noted that there has not been corresponding growth in facilities and techniques to support the collection, organization, processing, and dissemination of this information.0073646_000014.txt

Page  14 LABOR-HEALTH, EDUCATION, WELFARE APPROPRIATIONS 913 Funds for Inaugurating Construction Grants Program Included in the 1967 budget are $7.5 million for inaugurating a construction grants program to begin upgrading the facilities of the Nation's biomedical libraries; $1.5 million for grants and contracts for research and development directed toward solving some of the difficult problems facing biomedical libraries in storing, retrieving, and transmitting biomedical information; $1 million for training grants to increase the number of medical librarians and related information specialists available to serve the country's biomedical libraries; $120,000 for special scientific projects; $780,000 for support of publi- cations, such as translations, bibliographies, critical reviews, indexes, and abstracts; and $2.7 million for grants to biomedical libraries for strengthening their resources and services. The budget also includes modest increases for our intramural direct service program activities. In summary, our total request is for $19,231,000 representing a net increase of $9,547,000 over 1966. The principal item of increase is $8,900,000 for use in carrying out the provisions of the Medical Library Assistance Act of 1965. Senator Hill. Doctor, you requested a total of $26,544,000 from the Department, didn't you? Dr. Cummings. That is correct. Department and Budget Bureau Cuts Senator Hill. The Department made a reduction of $56,000 and then the Budget Bureau cut your request by $7,257,000. Is that correct? Dr. Cummings. I believe that is correct, sir. Senator Hill. I believe the principal reductions were $2.5 million for construction grants, $2.5 million for regional libraries, and $725,700, and 30 positions, for direct operations. Is that right? Dr. Cummings. That is about right, sir. Effect of Reduction Senator Hill. What is going to be the result of this reduction of $7,257,000? Dr. Cummings. I believe the net effect of this reduction will be to inhibit the development of the Nation's biomedical library system. But I think the funds in the President's budget permit us to make a good start in all areas with the exception of regional medical libraries for which no funds are available. Senator Hill. No funds at all for the regional libraries? Dr. Cummings. That is correct. Senator Hill. How much did you ask for the regional libraries? Dr. Cummings. The library requested $2.5 million for fiscal year 1967. Senator Hill. Did the Department cut that? Dr. Cummings. The Department supported the Library's request across the board. In fact, in one area the Department was more generous than the Library's own request.0073646_000015.txt

Page  15 914 LABOR-HEALTH, EDUCATION, WELFARE APPROPRIATIONS Reduction in Personnel With respect to the second portion of your question, reduction in personnel, 1 think it is fair to say that I would have some concern about the prudent management of a budget of this size without concomitant increases in staff. Senator Hill. You were reduced in your request for positions? Dr. Cummings. We were reduced by 46 positions in the aggregate. Senator Hill. Where would those positions have been? Dr. Cummings. Sixteen of these positions would have been for management of the seven programs authorized by the Medical Library Assistance Act of 1965. The remaining 30 positions would be used to improve the services within the National Library of Medicine. Senator Hill. The services within the Library itself? Dr. Cummings. Yes, sir. Senator Hill. Is there anything you would like to add? Mr. Isbister. We could submit a statement on the positions for the record. Senator Hill. You may submit that for the record, Doctor. (The statement follows:) Analysis of 46 Positions Cut From National Library of Medicine 1967 Budget as a Result of Bureau of the Budget Action 1. Review and Approval Necessary funds and 16 positions were requested to provide personnel required to review and evaluate an increased number of grant applications and contract proposals, administer the expanding overall extramural program, and to administer the construction grants program which is new in 1967. All 16 of the positions were cut as a result of the Bureau of the Budget's overall reduction of 46 positions: Deputy Associate Director.........------------------------------- GS-15 Chief, Facilities and Resources Division____________________________ GS-15 Research operations officer____________________________------------ GS-14 Training operations officer_________________________________________ GS-14 Construction program officer_______________________________________GS-14 Library resources officer_______________;___________________________ GS-13 Committee management assistant__________________.....__________ GS-7 Nine grants processing and clerical positions________________________ GS-2 to GS-6 2. Improving Bibliographic Services through MEDLARS This program was designed to provide more thorough indexing of medical literature, expansion of "demand search" services and accomplishment of increased workload in computer operations. Twelve positions were requested and the following six were cut as a result of the Bureau of the Budget reduction: Systems analyst___________________________________________________ GS-14 Searcher_________________________________........._______________GS-9 Searcher....._______________....._________________________.......GS-9 Indexer trainee____________________________________________________ GS-7 Clerk-typist____________..........._______________________________ GS-3 Commissioned officer________________-________________________....._________ S. Automation of Technical Services This program will permit the Library to implement a centralized service that will make cataloged information about new publications more readily accessible throughout the country. The costs of duplicative cataloging, a major factor in all research library budgets, will be reduced. These positions will enable the Library to begin applying automatic data processing techniques in acquiring literature and maintaining serial records. Eight positions were requested and the following three were cut as a result of the Bureau of the Budget reduction: Cataloger_________________________________......._______......_._ GS-9 Acquisition clerk___________________________________________________ GS-7 Clerk-typist......................................._............. GS-30073646_000016.txt

Page  16 LABOR-HEALTH, EDUCATION, WELFARE APPROPRIATIONS 915 4. Drug literature program The drug literature program provides special emphasis within the Library for the acquisition, analysis, and dissemination of published information on the effects of drugs and chemicals on man and animals, utilizing existing library services such as MEDLARS, indexing, cataloging and searching to process, service and disseminate information in the drug literature. All funds and the 10 positions that follow were cut as a result of the Bureau of the Budget reduction: Scientist.......__________________________________________________ GS-14 Medical subject headings specialist_________________________________ GS-12 Medical subject headings specialist_________________________________ GS-12 Indexing coordinator______________________________________________ GS-11 Indexer______________________________________________________ GS-9 Indexer........______________________________________________ GS-9 Secretary.---------------_____________________________________ GS-5 Clerk-typist______________________________________________________ GS-4 Clerk-typist______________________________________________________ GS-4 Commissioned officer______________________________________________ _____ 5. Strengthening Library Management Nine positions were requested to perform increased administrative and publi- cations management responsibilities resulting from the expansion of library programs. The following eight positions were cut as a result of the Bureau of the Budget reduction: Management analyst______________________________________________ GS-13 Publications management officer__________________________:__________ GS-12 Contracts officer________________,_________________________________ GS-12 Exhibits director______________________________________________ GS-11 Administrative officer___________„.»___________,___,________________ GS-9 Secretary_______________________i________________________________ GS-5 Clerk-typist__________......____u__________.......______________ GS-4 Clerk-typist.............________......._......._._______......._. GS-4 6. Historical research and training . This program would provide (a) assistance and consultation of a high caliber to visiting scientists interested in historical literature and (b) postgraduate train- ing for research fellows and other students. All funds and both positions re- quested were cut as a result of the Bureau of the Budget reduction: Historian________________________________________________________ GS-15 Librarian__________________________________________________ GS-11 7. Expanding the collection The purpose of this program is to expand the scope of coverage, accelerate the purchase of literature, and to catalog the additional literature acquired. Five positions were requested and only four were authorized as a result of the Bureau of the Budget reduction. The following position was cut: Commissioned officer_________________________________________ Senior grade History of Medicine Program Senator Hill. As I recall last year we added $30,000 for the history of medicine, is that correct? Dr. Cummings. That is correct, sir. Senator Hill. What does this budget provide? Dr. Cummings. These funds were used for the support of several research grant projects being carried out by historians, medical historians, in universities. Senator Hill. How much will you have for this year? Dr. Cummings. I believe the current budget for this program is in the neighborhood of $180,000. I had better check that figure. Senator Hill. You can supply that for the record. Dr. Cummings. All right, sir.0073646_000017.txt

Page  17 916 LABOR-HEALTH, EDUCATION, WELFARE APPROPRUTIONS (The information follows:) Funding for history of medicine grants in 1966 was raised to $120,000, the 1965 level, as the result of a congressional increase of $30,000. In 1967 the history of medicine grants program is included under the research and development grants and training programs, authorized by the Medical Library Assistance Act of 1965; however, 1967 awards in the History of Medicine grants program will approximate $200,000. Estimate for Microfilm Program Senator Hill. Then we made additions, I think, last year for expedited programing of microfilms, did we not? Dr. Cummings. Yes, sir. The Congress was quite generous in providing the Library with $220,000 to enable us to formalize a program for the preservation of our deteriorating records. Senator Hill. How much do you have in the present budget for that? Dr. Cummings. The present budget requests an additional $50,000 for augmentation of this effort. Senator Hill. Will that do the job? Dr. Cummings. I believe it will permit us to make reasonable progress with this problem. Senator Hill. In other words, you will make progress. Dr. Cummings. Yes, sir; I believe we will make progress. Senator Hill. If Dr. John Shaw Billings were to return to this earth, he would not be able to recognize his child, there has been so much progress. I don't suppose they had any microfilming in his day? Dr. Cummings. No, sir: I don't believe they had microfilming as we know it today. They did, of course, have rather good quality photography at that time. Senator Hill. Not like we have today. Dr. Cummings. No, sir; Library microfilming as we know it today was started in the National Library of Medicine by Dr. Atherton Siedel in 1938. That is one of the "firsts" that we are proud of in this institution. Senator Hill. He was one of the pioneers in this field as far as the Medical Library is concerned? Dr. Cummings. He was one of the very first to develop micro- filming for these purposes. Senator Hill. You have brought us a good statement. Is there anything else you would like to add? Dr. Cummings. No, sir; I think this covers it. Senator Hill. I want to thank you very much. We certainly appreciate it, Doctor, very much indeed. Dr. Cummings. Thank you, Mr. Chairman.